Individual
BRIAN WALTER PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
482 INTERSTATE DR STE 102, MANCHESTER, TN 37355-3485
(931) 488-8700
(931) 735-6456
Mailing address
111 MOSBY CT, SHELBYVILLE, TN 37160-7179
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
2291
TN
207X00000X
Orthopaedic Surgery Physician
TL1160
WY
Other
Enumeration date
05/28/2007
Last updated
09/30/2025
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